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Migraine Headaches and Nutrition Approaches

15 Jul

People with migraines know all too well about that throbbing, pulsating, and nauseated feeling that accompanies their headaches and the associated disability that often results. The underlying cause of migraine headaches is still not well understood, but genetics (family history), chemical imbalances in the brain (serotonin, in particular), environmental factors (weather, allergens), and hormonal changes appear to play a part. Because medications to manage headaches can come with potentially serious side effects, especially with prolonged use, many patients opt for non-pharmaceutical treatment approaches to reduce the frequency and intensity of their migraines…

A 2018 survey of 4,356 American adults with a history of migraines found that common symptoms associated with migraines include sensitivity to touch (32%), food cravings (28%), and hallucinations (18%), which include sound and smell. The most common foods to trigger a migraine were chocolate at 75%, cheese (especially aged cheeses) at 48%, citrus fruit at 30%, and alcohol (especially red wine) at 25%. Other foods that may be triggers include cured meats, monosodium glutamate (MSG), aspartame (and other artificial sweeteners), snack foods, fatty foods, dairy products, food dyes, coffee, tea, cola, and nuts.

According to a 2019 study, people who suffer from migraines are often deficient in magnesium (Mg), a mineral naturally found in spinach, nuts, and whole grains. Magnesium is also important in regulating blood pressure, blood sugar (glucose), and muscle and nerve function. A meta-review of previous study findings revealed that migraine patients who received a Mg supplement reported reductions in both headache frequency and intensity. Other benefits included a decrease in hospitalization during pregnancy, and at a higher dose, a lower incidence of type-2 diabetes and stroke!

Another nutritional anti-migraine option includes the use of fever few (Tanacetum parthenium) for both prevention and treatment of migraine headaches. Other benefits of fever few include fever reduction, irregular menstrual cycles, arthritis, psoriasis, allergies, asthma, tinnitus, dizziness, and nausea/vomiting. There is also research support for the use of riboflavin (vitamin B-2), melatonin and coenzyme Q10 by migraine patients.

Doctors of chiropractic often manage their migraine headache patients using a multi-modal approach that includes cervical spinal manipulation and mobilization, physical therapy modalities, home exercise training, nutritional counselling (including supplementation advice), and other conservative treatment approaches based on the patient’s specific needs.

 

This information should not be substituted for medical or chiropractic advice. Any and all healthcare concerns, decisions, and actions must be done through the advice and counsel of a healthcare professional who is familiar with your updated medical history.
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Neck-Specific Exercise for Headaches & Neck Pain

13 Jun

As screens (televisions, computers, and smartphones/tablets) become an increasingly important part of daily life, many people gradually take on a more slumped posture, which can place added strain on the neck and shoulders, raising the risk for neck pain and headaches. Luckily, it’s possible to improve forward head posture, rounded shoulder posture, and scapular instability with neck-specific exercises and chiropractic care.

In a 2018 study, patients with forward head posture performed either scapular stabilization or neck stabilization exercises for 30 minutes three times a week for four weeks. Participants in both groups experienced improvements related to their craniocervical angle and muscle activity around the upper back and neck, with greater results reported by the scapular stabilization group.

Several studies have shown similar results for improving forward head posture using both scapular and neck stabilization exercises. In another study, high schoolers with forward head posture performed scapular and neck stabilization exercises and exhibited good posture up to four months later.

A 2019 study looked at the effect of a six-week intervention featuring manual therapy and/or stabilizing exercises on 60 women with neck pain and forward head posture. Participants in both the manual therapy/stabilization exercise-combo group and the stabilization exercises-only group reported better outcomes with respect to head posture, pain reduction, and improved function, but the results were best in the combined treatment group. The authors concluded that manual therapy adds a meaningful role to a structured exercise program that addresses scapular and neck instability and forward head and rounded shoulder posture.

Doctors of chiropractic often incorporate exercise training in their treatment recommendations, especially when postural issues may contribute to the patient’s symptoms, like neck pain and headaches.

 

This information should not be substituted for medical or chiropractic advice. Any and all healthcare concerns, decisions, and actions must be done through the advice and counsel of a healthcare professional who is familiar with your updated medical history.

Chiropractic Methods for Treating Neck Pain

13 May

When it comes to neck pain, many patients seek out chiropractic care. In fact, there are several studies demonstrating that manual therapies performed by doctors of chiropractic can offer significant benefits for non-specific or mechanical neck pain as well as neck pain arising from injuries related to sports, car accidents, and falls. What are some of these manual therapies?

Spinal manipulative therapy (SMT) involves moving the head and neck to a firm end-range of movement followed by a fast, thrust aimed at specific joints that are fixed, subluxated (partially out of position), and tender. The thrust is described as a “high-velocity, low amplitude” (HVLA) movement, and it’s also called “an adjustment”, which is more unique to the chiropractic profession. Joint cavitation (the “cracking” sound) often occurs as gas (nitrogen, oxygen, carbon dioxide) either forms within or is released from the joint.

Spinal mobilization (SM) is a low-velocity, low amplitude movement that is typically slow and rhythmic, gradually increasing the depth of a back-and-forth movement, often combined with manual traction. Here, joint cavitation is less common.

Exercise training that focuses on strengthening the deep neck flexor muscles and other exercises that are specifically designed for each individual patient based on their specific needs can result in better treatment outcomes compared to a generalized, non-specific exercise program. Studies in which SMT/SM and exercise are combined report better long-term outcomes than SMT/SM alone, but SMT/SM typically out-performs exercise therapy alone.

Physical therapy modalities (PTM) can include ultrasound, interferential, low and high volt, galvanic current, diathermy, lasers (class 3B and IV primarily), ultraviolet, ionto- and phono- phoresis, pulsed electro-magnetic field, hot/cold, and more.

Muscle release techniques (MRTs) include massage therapy, myofascial release, trigger point therapy, muscle energy techniques, active release therapy, gua sha, and many more.

Cervical traction devices can be used either in the office or at home, depending on the patient’s needs; however, it’s common for both approaches to be used. The obvious benefits of home traction include the ability to repeat its use multiple times a day, and it’s generally more cost effective. Types include static traction that can be applied sitting or supine (on the back) and intermittent traction, which is typically performed supine and is computerized, and hence, is often limited to in-office use only.

Which approaches are used in the course of care depend on the preference of the patient as well as the treating chiropractor. It’s important to discuss your preferences with your chiropractor when seeking care.

 

This information should not be substituted for medical or chiropractic advice. Any and all healthcare concerns, decisions, and actions must be done through the advice and counsel of a healthcare professional who is familiar with your updated medical history.

Let’s Have Some “Pillow Talk!”

18 Apr

Individuals with neck pain may find it difficult for get a night of restful, restorative sleep due to pain keeping them awake or interrupting their slumber. Not only can a restless night make it more difficult to complete tasks related to everyday living or make neck pain worse, but poor sleep habits over time can raise one’s risk for chronic disease and even early death—perhaps as much as physical inactivity or a bad diet. When treating a patient with neck pain, doctors of chiropractic often inquire about the patient’s sleeping position and pillow, as addressing these factors may be important for getting a good night’s rest.

When it comes to a “good” position for the head while sleeping, most experts would recommend assuming a position that most closely mimics a good upright posture. If lying on the back, the head should not be forced toward the chest (hyper-flexed) or dropped too far backward into hyper-extension. When lying on the side, the head should not be forced upward or downward, away from the neutral position. If you habitually sleep on your stomach—which is generally NOT a good position for the neck due to the prolonged static rotation—you may want to consider a very thin pillow (or not using a pillow) to not force the neck too far up or down when rotated. Placing a body-pillow between the knees that extends up in front of the pelvis and chest can function as a “kick-stand” to keep you from rolling onto your stomach during the night.

What about pillow materials?  There are many to choose from, such as feathers, foam (memory and others), water, buckwheat, and/or combinations of these. While there is probably not a “best” choice, there are characteristic differences that are worth discussing. For example, memory foam molds nicely to the contours of the head and neck but can be hot and may have an unpleasant odor. Latex foam has the advantage of molding well to contours without becoming hot and comes in various densities to suit preferences, which can be quite helpful for those with neck pain and headaches. Generally, higher density foam offers less breakdown and more support. Latex is also resistant to mold and dust mites, another distinct advantage. Feathers and down pillows can mold to fit the body contours nicely but have a tendency to lose that initial position as the feathers often spread out while sleeping. Some people are also bothered by allergies or skin sensitivities making feather pillows and certain types of foam undesirable. Buckwheat hulls tend to mold well and be cool but then can be noisy when moving. Mattress firmness should also be taken into consideration, as the amount of “sinking in” will affect the pillow thickness decision.

If musculoskeletal pain is interfering with your sleep, consult with your doctor of chiropractic to help determine the best position and pillow for your individual case. Your chiropractor may also offer nutritional recommendations with the aim of improving sleep quality.

This information should not be substituted for medical or chiropractic advice. Any and all healthcare concerns, decisions, and actions must be done through the advice and counsel of a healthcare professional who is familiar with your updated medical history.

Can the Cervical Spine Cause Shoulder Pain?

18 Mar

Subacromial impingement (SAI) is a common injury in sporting activities that require overhead motions, especially among pitchers, quarterbacks, and swimmers. Not everyone responds to treatment to the same degree, and a new study that reviewed two specific cases may offer a possible reason: the neck.

One of the two cases involved a high school football quarterback and the other a collegiate swimmer. Both participants presented with signs and symptoms of subacromial impingement with minimal neck complaints and few clinical signs that initially supported neck involvement.

Of interest, both patients had poor posture that included forward head carriage and rounded forward shoulders. During the initial examination, both had shoulder pain and weakness while raising their arm up from the side, a “classic” sign of rotator cuff muscle injury and subacromial bursitis. However, neither case did well when treatment addressed only the shoulder, prompting their doctors to test whether or not the patients’ poor posture had a role in their shoulder discomfort.

Once the patients performed chin retraction exercises followed by chin retraction plus extension exercises (three sets of ten repetitions) to improve their posture, they experienced a complete improvement in shoulder impingement and muscle weakness.

The author suspects that both patients experienced intermittent irritation of the C5 nerve root in the neck, which innervates the rotator cuff muscles, leading to their shoulder pain and weakness. In both cases, the two athletes performed home-based exercises and returned to their sports and did not have further problems during the rest of the season.

These two cases are GREAT examples of why doctors of chiropractic evaluate the whole patient to identify any and all factors that may contribute to a patient’s chief complaint. It is very common to find cervical spine joint dysfunction in patients with shoulder pain, and success in treatment favors treating both areas, of which (as noted in these case studies) the neck may be the most important focus.

Can Chiropractic Adjustments Help Headaches?

18 Feb

Experts report that 157 million work days are lost each year in the United States due to headaches at a cost of about $50 billion in work absenteeism and medical expenses. According to current estimates, about 18% of chronic headache patients are believed to have cervicogenic headaches (CGH), or headaches that originate from dysfunction in the neck.

Many CGH sufferers utilize complementary and integrative health treatment approaches for neck pain and headaches, of which spinal manipulative therapy (SMT) is the most common. While past studies have demonstrated SMT to be a superior form of treatment for CGH, no one has investigated how many treatments are needed to achieve the maximum clinical benefit for CGH patients – at least not until recently!

In order to determine what dose of SMT may best benefit patients with headaches originating from the neck, researchers randomized 256 CGH patients into four treatment groups that received 0, 6, 12, or 18 SMT treatments over the course of six weeks. The researchers found a dose-dependent relationship between SMT and days without CGH over the following year with patients in the 18 visit group experiencing 16 fewer days with CGH over the next twelve months than those in the zero treatment group.

The chiropractic spinal manipulative therapy treatment used in the study consisted of high-velocity, low-amplitude thrust manipulation in the neck and upper back regions (specifically, occiput to T3) aimed at sites with detected joint dysfunction (fixation or pain), which is typically the method most chiropractors determine where to apply spinal manipulation.

This study is VERY important for a few reasons: 1) it proves SMT helps patients with CGH; 2) it provides doctors of chiropractic with an idea of how many visits it may take to obtain optimum results; and 3) it can be used as a guideline when managing CGH patients, stressing the important point that EACH patient is UNIQUE and modifications may be appropriate depending on each case.

 

This information should not be substituted for medical or chiropractic advice. Any and all healthcare concerns, decisions, and actions must be done through the advice and counsel of a healthcare professional who is familiar with your updated medical history.